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Re: kgromax post# 146576

Saturday, 02/13/2021 12:05:03 AM

Saturday, February 13, 2021 12:05:03 AM

Post# of 233240
Kgro,

Are you sure about this statement?

2) BUT the Toci study selected only patients with a C-Reactive Protein (CRP) above 75mg/L.
Which are patients with a much higher mortality risk.



Evidence demonstrates that 75 mg/l CRP is relatively low in the context of severe covid and its impact on mortality.

Elevate mortality is in fact seen in CRP over 200 mg/l.

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242400

he median CRP during hospitalization for the entire cohort was 130 mg/L (IQR 82–191 mg/L), and the median CRP on ICU admission was 169 (IQR 111–234). The hospitalization-wide median CRP was significantly higher amongst the patients who died, compared to those who survived [206 mg/L (157–288 mg/L) vs 114 mg/L (72–160 mg/L), p<0.001].



The vaunted tocilizumab CRP inclusion criteria of 75 mg/l is not predictive of increased of mortality.

Additionally, it is profoundly difficult to argue that, despite the 33% mortality rate, that the RECOVERY trial inclusion criteria selected for critical patients.

For review what are those inclusion criteria?

Adult patients ≥18 years of age
Clinically suspected or confirmed SARS-CoV-2 infection
Hypoxia: O2 sat <92% on room air or requiring O2 therapy
Evidence of systemic inflammation: CRP ≥75mg/L



We seem to be missing typical indicators of severe and critical covid?

Where are:

Aggressive respiratory therapies?

high flow oxygen
non-invasive ventilation
invasive ventilation (intubation)
ECMO

Evidence of end organ insult or failure

multi-organ dysfunction (elevate SOFA score)
hypotension
tachycardia

I would offer that the Leronlimab CD12 trial enrolled patients substantially more critically ill than those in the failed tocilizumab RECOVERY trial.

Nonetheless, none of us outside these trials really know.

I'll wait and see the results my self very soon.
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